Fatih Tanrıverdi, Gül Pamukçu Günaydın, Alp Şener

Mechanical Versus Manual Chest Compression: A Retrospective- Cohort in Out-of-Hospital Cardiac Arrest

Objective: In cardiac arrest cases, high quality cardiopulmonary resuscitation and effective chest compression are vital issues in improving survival with good neurological outcomes. In this study, we investigated the effect of mechanical chest compression devices on 30- day survival in out-of-hospital cardiac arrest. Materials and Methods: This retrospective case-control study was performed on patients who were over 18 years of age and admitted to the emergency department for cardiac arrest between January 1, 2016 and January 15, 2018. Manual chest compression was performed to the patients before January 15, 2017, and mechanical chest compression was performed after this date. Return of spontaneous circulation, hospital discharge, and 30-day survival rates were compared between the groups of patients in terms of chest compression type. In this study, the LUCAS-2 model piston-based mechanical chest compression device was used for mechanical chest compressions. Results: The rate of return of spontaneous circulation was significantly lower in the mechanical chest compression group (11.1% vs 33.1%; p < 0.001). The 30-day survival rate was higher in the manual chest compression group (6.8% vs 3.7%); however, this difference was not statistically significant (p = 0.542). Furthermore, 30-day survival was 0% in the trauma group and 0.6% in the patient group who underwent cardiopulmonary resuscitation for over 20 minutes. Conclusion: It can be seen that the effect of mechanical chest compression on survival is controversial; studies on this issue should continue and, furthermore, studies on the contribution of mechanical chest compression on labor loss should be conducted.

PDF

___

[1] Brodal Syversen K, Souvannasacd E, Renger R. Validating the LUCAS® mechanical chest compression fit specifications. Am J Emerg Med. 2019;37(2):371-3. doi: 10.1016/j.ajem.2018.06.069.
[2] Sarıaydın T, Çorbacıoğlu ŞK, Çevik Y, et al. Effect of initial lactate level on short-term survival in patients with out-ofhospital cardiac arrest. Turk J Emerg Med. 2017;17(4):123- 7. doi: 10.1016/j.tjem.2017.05.003. eCollection 2017 Dec.
[3] Bonnes JL, Brouwer MA, Navarese EP, et al. Manual Cardiopulmonary Resuscitation Versus CPR Including a Mechanical Chest Compression Device in Out-of- Hospital Cardiac Arrest: A Comprehensive Meta- Analysis from Randomized and Observational Studies. Ann Emerg Med. 2016;67(3):349-60. doi: 10.1016/j. annemergmed.2015.09.023.
[4] Putzer G, Braun P, Zimmermann A, et al. LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue-a prospective, randomized, crossover manikin study. Am J Emerg Med. 2013;31(2):384-9. doi: 10.1016/j.ajem.2012.07.018.
[5] Poole K, Couper K, Smyth MA, et al. Mechanical CPR: Who? When? How? Crit Care. 2018;22(1):140. doi: 10.1186/ s13054-018-2059-0.
[6] Gyory RA, Buchle SE, Rodgers D, et al. The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study. West J Emerg Med. 2017;18(3):437-45. doi: 10.5811/westjem.2017.1.32575.
[7] Rubertsson S, Lindgren E, Smekal D, et al. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-ofhospital cardiac arrest: the LINC randomized trial. JAMA. 2014;311(1):53-61. doi: 10.1001/jama.2013.282538.
[8] Wik L, Olsen JA, Persse D, et al. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation. 2014;85(6):741-8. doi: 10.1016/j. resuscitation.2014.03.005.
[9] Brooks SC, Bigham BL, Moririson LJ. Mechanical versus manual chest compressions for cardiac arrest. Cochrane Database Syst Rev. 2011;1:CD007260. doi: 10.1002/14651858.CD007260.pub2.
[10] Brooks SC, Hassan N, Bighm BL, et al. Mechanical versus manual chest compressions for cardiac arrest. Cochrane Database Syst Rev. 2014;2:CD007260. doi: 10.1002/14651858.CD007260.pub3.
[11] Smekal D, Johansson J, Huzevka T, et al. A pilot study of mechanical chest compressions with LUCAS device in cardiopulmonary resuscitation. Resuscitation. 2011; 82:702-6. doi: 10.1016/j.resuscitation.2011.01.032.
[12] Gates S, Quinn T, Deakin CD, et al. Mechanical chest compression for out-of-hospital cardiac arrest: systematic review and meta-analysis. Resuscitation. 2015; 94:91–7. doi: 10.1016/j.resuscitation.2015.07.002.
[13] Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. 2010;122(18 Suppl 3):729-67. doi: 10.1161/CIRCULATIONAHA.110.970988.
[14] Travers AH, Rea TD, Bobrow BJ, et al. Part 4: CPR overview: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. 2010;122(18 Suppl 3):676-84. doi: 10.1161/CIRCULATIONAHA.110.970913.
[15] Newberry R, Redman T, Ross E, et al. No Benefit in Neurologic Outcomes of Survivors of Out-of- Hospital Cardiac Arrest with Mechanical Compression Device. Prehosp Emerg Care. 2018;22(3):338-44. doi: 10.1080/10903127.2017.1394405.
[16] Wang PL, Brooks SC. Mechanical versus manual chest compressions for cardiac arrest. Cochrane Database Syst Rev. 2018;8:CD007260. doi: 10.1002/14651858.CD007260. pub4.
[17] Hallstrom A, Rea TD, Sayre MR, et al. Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. JAMA. 2006;295(22):2620- 8. doi: 10.1001/jama.295.22.2620
[18] Perkins GD, Lall R, Quinn T, et al. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomized controlled trial. Lancet. 2015;385(9972):947-55. doi: 10.1016/S0140- 6736(14)61886-9.
[19] Lyon RM, Crawford A, Crookston C, et al. The combined use of mechanical CPR and a carry sheet to maintain quality resuscitation in out-of-hospital cardiac arrest patients during extrication and transport. Resuscitation. 2015; 93:102-6. doi: 10.1016/j.resuscitation.2015.05.030.
[20] Cheskes S, Byers A, Zhan C, et al. CPR quality during outof- hospital cardiac arrest transport. Resuscitation. 2017; 114:34–9. doi: 10.1016/j.resuscitation.2017.02.016.
[21] Roosa JR, Vadeboncoeur TF, Dommer PB, et al. CPR variability during ground ambulance transport of patients in cardiac arrest. Resuscitation. 2013;84(5):592–5. doi: 10.1016/j.resuscitation.2012.07.042.
[22] Hayashida K, Tagami T, Fukuda T, et al. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients with Nontraumatic Out-of-Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS-KANTO (Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area) 2012 Study). J Am Heart Assoc. 2017;6(11). pii: e007420. doi: 10.1161/JAHA.117.007420.
[23] Hock Ong ME, Fook-Chong S, Annathurai A, et al. Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department. Crit Care. 2012;16(4): R144. doi: 10.1186/ cc11456.